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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KACIE JO COSTELLO MOODY, PA

Active

KACIE JO COSTELLO MOODY, PA is a Physician Assistant healthcare provider located in FORT MILL, South Carolina. NPI 1841461373 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · FORT MILL, SC

Registration Details

NPI Number
1841461373
Provider Type
Individual
Gender
Female
NPI Issued
Mar 12, 2008 (18.438008016979 yrs)
Last Updated
Jul 21, 2022
Licenses
0010-00779 (NC)
1295 (SC)

Practice Information

Address
704 GOLD HILL RD
SUITE 1200
FORT MILL, SC, 297158906
Browse SC providers · Browse ZIP 29715
Phone
7046673380
Fax
7046673381
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in FORT MILL, SC

Name Credential NPI
SHERRY D. SHERMAN P.A-C 1376571547
MICHAEL PATRICK ROBERTS PA-C 1922036862
MRS. HEATHER ELIZABETH SHIFLETT PA-C 1619901568
MRS. SHAWNIE RENEE PERKINS MSPAS, PA-C 1740477207
MRS. NICOLE C KEETER PA-C 1396997110
KISHOR VALAJIBHAI PATEL PA-C 1841613437
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.